MR纳米分子影像探针靶向示踪口腔鳞状细胞癌研究进展

既往对口腔鳞状细胞癌(OSCC)细胞在体内迁移能力进行实验分析时,多采用侵袭性方法,即在细胞移植后一定时间内处死实验动物,对其口腔颌面部组织进行病理切片分析,并不能对同一实验动物OSCC细胞在体内的迁移和增殖情况进行动态观察。近年来,随着非侵袭性检查手段不断进步,通过以纳米颗粒作为对比剂的MR检查技术,可标记OSCC细胞内高度特异性表达的蛋白,从而靶向示踪其在体内的迁移,并由此推测OSCC的具体分期。本文主要对MR纳米分子探针靶向示踪OSCC的研究进展进行综述。     

胃癌转移淋巴结评估手段的研究现状及远景

准确判断胃癌转移淋巴结是精确手术治疗胃癌的前提.现有的影像学手段尚不能获得满意效果.前哨淋巴结的示踪及快速活检是目前最常用的术中判断胃癌转移淋巴结的方法,仅限用于早期胃癌.纳米材料应用于胃癌转移淋巴结的影像学显影及术中示踪是一个新兴领域,但迄今用于研究胃癌转移淋巴结的纳米材料必须依赖淋巴系统的有效回流,而进展期胃癌的淋巴管常被癌细胞阻塞,使其应用受到限制.至今缺乏满意的胃癌转移淋巴结影像学显影及术中示踪手段.本文综述了高分子纳米靶向微球的作用特点,根据现有的研究结果,提出了新型靶向多功能纳米微球用于精确评估胃癌转移淋巴结的设想.     

肾细胞癌靶向治疗预后相关因素研究进展

肾细胞癌（RCC）是泌尿系统常见的恶性肿瘤之一。分子靶向治疗是通过干预肿瘤细胞信号传导通路,抑制肿瘤的生长。相比于传统的细胞冈子治疗手段．肾癌靶向治疗效果更好。但是目前对肾癌靶向治疗的预后仍缺乏有效判断手段,本文结合最新研究综述了RCC靶向治疗预后密切相关的影响冈素研究现状及进展。     

磁感应治疗肿瘤新技术研究现状

传统的治疗方法如手术、放射治疗和化学药物治疗仍是当今国际医学界治疗恶性肿瘤的三大支柱。热疗是近年来发展较快的一种肿瘤治疗手段，是指用加热的方法使人体癌变处的局部温度升高从而杀死癌细胞的一种治疗方法，目前，局部热疗按治疗时所产生的温度可以分为三大类，即温热疗法（42～46℃）、高温疗法（46～70℃）和热切除（〉70℃）。热疗作为一种物理治疗方法，同化疗、放疗相比较少受副作用的限制，这使得热疗可以多次重复，而不用像化疗、放疗那样考虑毒性副作用在体内的积累，因而在肿瘤治疗中具有良好的应用前景。[第一段]     

磁感应纳米基因靶向治疗方法的研究与展望

磁感应纳米基因靶向治疗方法是一种联合磁感应热疗和热诱导基因治疗的综合肿瘤治疗方法。磁性纳米颗粒既是磁感应热疗的核心介质,也可以作为肿瘤基因治疗的非病毒载体。如果我们采用热诱导启动子来控制治疗基因表达,利用磁性纳米颗粒载体携带治疗基因进入靶细胞,那么在交变磁场的作用下,磁性纳米颗粒感应升温就能够激活热诱导启动子,     

超顺磁性氧化铁纳米颗粒标记干细胞的研究进展

超顺磁性氧化铁纳米颗粒(SPIONs)是一种在细胞标记、药物靶向投递、肿瘤热治疗等领域,都有着广泛应用前景的纳米材料。再生医学研究中,干细胞的研究和应用广受关注,SPIONs的出现为干细胞的标记和示踪提供了新的途径。SPIONs具有超顺磁性、低毒性、良好生物相容性,以及在外加磁场下定向移动等特点。SPIONs在MRI成像上表现为信号减弱区域,经过表面修饰后可有效、安全地标记干细胞,但同时也存在细胞毒性不明确和MRI成像限制性等问题。本文就超顺磁性氧化铁纳米颗粒标记干细胞的研究进展进行综述。     

交变磁场感应肿瘤热疗设备的研究

随着热生物学、热生理学与电子技术的综合发展,肿瘤局部热疗成为近年国际肿瘤治疗的研究热点。肿瘤局部热疗(hyperthermia)希望能适形把癌瘤组织加热到46～70℃有效治疗温度范围,并维持一段时间,使癌细胞受到毁灭性的打击,并刺激机体免疫系统,增强机体对肿瘤的免疫力;同时要避免正常组织的过热损伤,减少患者不能忍受的各种创伤和威胁患者生命的并发症。与手术、放疗和化疗3种传统方法比较,肿瘤热疗处于辅助和次要地位,但有巨大开发和应用潜能。目前,用于肿瘤局部热疗的方法主要有射频加热、微波加热、超声波加热等[1],但这些方法各自存在一…     

晚期肾癌的分子靶向治疗进展

确诊肾癌时大多已属晚期,失去了手术机会.常规化疗、放疗及内分泌激素治疗效果较差.近年来,而分子靶向治疗在肿瘤中的治疗已取得显著进展.本文对晚期肾癌分子靶向治疗新进展进行简要阐述.     

Fe2O3纳米磁流体热疗治疗肝癌

目的　研究在一定高频交变磁场不同浓度的Fe2 O3 纳米磁流体热疗对SMMC772 1肝癌的治疗作用。方法　光学显微镜、电子显微镜观察细胞形态 ,四甲基偶氮唑蓝 (MTT )比色法检测Fe2 O3 纳米磁流体热疗 (MFH)对SMMC772 1肝癌细胞株生长的影响 ,流式细胞仪 (FCM )检测凋亡细胞 ,荷瘤鼠热疗实验检测MFH对肝癌的肿瘤体积抑制率及质量抑制率。结果　SMMC772 1细胞经Fe2 O3 纳米磁流体热疗作用后 ,细胞增殖受到明显抑制 ,细胞凋亡率明显增加 ,且与磁流体浓度呈依赖关系 ;动物实验显示纳米磁流体热疗对肝癌的体积和质量有明显的抑制作用。结论　Fe2 O3 纳米磁流体热疗能抑制肝癌SMMC772 1细胞增殖 ,促进其凋亡 ,并对肝癌显示明显的体积和质量抑制效应 ,对肝癌的治疗有一定的作用。     

肝内胆管癌临床研究现状

肝内胆管癌（ICC）的病因复杂，且高度侵袭、高度异质、预后不良。近年来ICC的临床诊断与治疗进展显著，主要包括功能与分子影像学技术提供了更精准的术前评估与复发监测新手段；分子分型与传统临床病理学分型结合为ICC的临床决策提供了更精准保障。手术切除仍是ICC的惟一根治性治疗手段，对R0切除、淋巴结清扫、术后辅助治疗以及复发再切除的意义得到肯定。局部治疗、分子靶向治疗及免疫治疗等新型疗法发展迅速，为晚期ICC带来新的希望。传统治疗手段与新型疗法的序贯、联合，“多兵种联合作战”是未来发展方向。     

Experimental and clinical studies on preoperative combined therapy using hyperthermia in carcinoma of the esophagus

In order to develop a new multidisciplinary treatment for carcinoma of the esophagus, we evaluate the effect of hyperthermia experimentally and clinically. Antitumor effect for squamous cell carcinoma arising spontaneously in a C3H/He Mouse is proved using hyperthermia only, and combined hyperthermia with irradiation and chemotherapy. Inhibited growth of tumor can lead to decrease of distant metastasis (Pulmonary metastasis). And hyperthermia itself does not induce increase of metastasis. There is a total of 32 patients of esophageal carcinoma receiving a preoperative combined treatment using hyperthermia. Nineteen patients received irradiation and hyperthermia. Thirteen received irradiation, immunochemotherapy and hyperthermia, Ef3 (complete disappearance of cancer cells) is obtained in 26.3% with the treatment using irradiation and hyperthermia, and 46.1% of Ef3 is found using irradiation, immunochemotherapy and hyperthermia. The above mentioned results are more favorable than the usual treatment using irradiation and immunochemotherapy without hyperthermia. Serrated, spiral, funnel type of esophagogram were used to be radiation resistant, however a satisfactory histological effect could be obtained by hyperthermia in addition to conventional irradiation. Because a high percentage of Ef3 is revealed even in A3 (invasion into the neighboring structures) cases, we can extend our indication of operation and our rate of curative resection is increased. Moreover, postoperative early local recurrence is decreased and it seems to improve the short term survival rate (3 years survival). We were afraid that combined treatment using hyperthermia might enhance remote lymph nodes metastases. But present study proves that it is not true. In conclusion, we recommend combined treatment using hyperthermia for A3 cases those are seemed to be difficult to resect because of invasion into the neighboring structures.     

The extracellular matrix in oral squamous cell carcinoma: Friend or foe?

Oral squamous cell carcinoma is a disfiguring, highly invasive and metastatic cancer. Despite advances in detection and therapy, many patients will continue to face a poor prognosis. It is well established that the predominate factor determining overall survival in patients with oral squamous cell carcinoma is lymph node involvement. Tumor growth and progression to invasive cancer requires tumor cell interactions with the extracellular matrix. An understanding of how the extracellular matrix influences tumor development and invasion is fundamental in the development of new prognostic indicators and treatment strategies for oral squamous cell carcinoma. In this review, we summarize how changes in the extracellular matrix contribute to oral cancer development.     

Hyperthermia potentiates the effects of aluminum phthalocyanine tetrasulfonate-mediated photodynamic toxicity in human malignant and normal cell lines.

The purpose of this study was to examine the effects of photodynamic therapy utilizing aluminum phthalocyanine tetrasulfonate in vitro on several human malignant and normal cell types, with or without hyperthermia. Cells examined included normal skin fibroblasts, HT-1080 fibrosarcoma cells, SCC-25 (squamous cell carcinoma) and malignant melanoma cells. An argon-pumped continuous wave tunable dye laser at 675 nm was used as the light source, hyperthermia groups were heated to 42.5 degrees C, and radioisotope incorporation was used to measure DNA and protein synthesis as toxicity assays. Results showed an energy-dose, and A1PcS-concentration dependent toxicity in all cell lines examined, with moderate selectivity toward malignant cells. Hyperthermia alone was slightly toxic in melanomas and HT-1080 cell lines but had no effect in normal fibroblasts or SCC-25 cells. Hyperthermia synergistically potentiated the effects of PDT in all cell lines, and the combined modality was significantly more toxic in all malignant cell lines compared with normal cells. Thus, addition of hyperthermia to PDT protocols may enhance the efficacy of this treatment modality in vitro.     

Carcinoma of male urethra: management of locally advanced disease with combined chemotherapy, radiotherapy, and penile-preserving surgery.

Squamous cell carcinoma of the urethra is a rare urologic malignancy. In spite of aggressive management with radical and often times disfiguring surgery and/or radiation therapy, prognosis remains poor. Initial success in treating squamous cell carcinoma of the esophagus and anal canal has been reported with a combined radiation and chemotherapy protocol. In hopes for improving the treatment outcome for patients with squamous cell carcinoma of the urethra, we have applied the new combination chemotherapy/radiation therapy protocol. Herein, we report the successful downstaging (clinical Stage C to pathologic Stage TO) and treatment of squamous cell carcinoma of the anterior urethra with combination chemotherapy/radiation therapy. This was followed with penile-preserving surgery to document local control of disease and to avoid the morbidity of a radical disfiguring operation.     

Combined treatment of rectal cancer using intensive macrofractional preoperative irradiation

The article discusses the results of a cooperative randomized study according to evaluation of the efficacy of combined treatment in 451 patients among which 248 patients received an intensive course of macrofractional irradiation in cumulative local dose of--25 Gr. Intensive macrofractional irradiation increases neither the frequency of postoperative complications nor the mortality rate. At the same time, the combined method of treatment leads to a significant reduction in the frequency of a recurrent tumor and an increase in 5-year survival, particularly among patients with a stage III tumorous process. Combination of radiotherapy and surgery with the use of local UHF hyperthermia is the method of choice in the treatment of squamous cell carcinoma of the anal canal.     

A case of long-term survival of advanced penile carcinoma treated with combination therapy

A 72-year-old man with genital ulcerative tumor was introduced to our hospital in December 1997. The pathological examination revealed well differentiated squamous cell carcinoma. A diagnosis by computed tomography and magnetic resonance imaging indicated that a locally advanced penile carcinoma had infiltrated the urethra, prostate, pubic bone and there was also bilateral inguinal lymphoadenopathy. Linac irradiation (40Gy/4 weeks) combined with once-a-week administration of THP-ADM were indicated. One month after the combination therapy, the tumor size had become small enough to allow curative surgical treatment. Pathological examination revealed no positive margin. For eight years since this radical treatment, the patient has been healthy with no local recurrence and no distant metastatic lesion.     

Swallow recovery in an oral cancer patient following surgery,radiotherapy, and hyperthermia

Background. No study has examined the nature and extent of swallowing impairment in oral cancer patients following treatment with combined hyperthermia and interstitial radiotherapy. Few studies have examined the effects of voluntary swallow maneuvers (supersupraglottic and Mendelsohn) on pharyngeal phase swallowing in the oral cancer patient treated with surgery or radiotherapy. This study examined the effects of combined radiotherapeutic salvage treatments of hyperthermia and interstitial implantation and swallow recovery using swallow maneuvers in a surgically treated and irradiated oral cancer patient. Methods. The patient under study, a 51-year-old man, underwent radiotherapy, according to Radiation Therapy Oncology Group (RTOG) protocol #8419, consisting of a combination of interstitial irradiation and hyperthermia to the base of tongue, for a recurrent squamous cell cancer. He underwent videofluorographic (VFG) examination of his swallowing, a modified barium swallow at three time points: 2 days following radiotherapy treatment (VFG1), 4 weeks later (VFG2), and 8 months later (VFG3). Temporal and biomechanical analyses of swallows were performed at each time point. Results. Swallow maneuvers and time resulted in improved laryngeal elevation and laryngeal vestibule closure during the swallows on VFG2. Maximum upper esophageal sphincter (UES) opening width and duration were more normal. Fewer swallows were required for bolus clearance through the pharynx. Base of tongue tissue necrosis occurred as a complication of radiotherapy between VFG2 and VFG3, with resultant severe reduction in posterior movement of the tongue base, incomplete tongue base contact to the posterior pharyngeal wall, reduced laryngeal elevation, and incomplete laryngeal vestibule closure during swallowing at VFG3. UES opening became less normal and a greater number of swallows were required for bolus clearance through the pharynx. Conclusions. Combined interstitial irradiation and hyperthermia can cause oropharyngeal swallowing problems. Time and swallow therapy can improve these swallow disorders. Tongue base tissue necrosis can cause further swallow impairment, emphasizing the importance of the tongue base in normal deglutition. Further studies are needed to examine the impact of combined hyperthermia and interstitial implantation for treatment of tongue base tumors on swallow functioning in a larger group of patients. © 1994 John Wiley & Sons, Inc.     

Enhanced antitumor effects of bleomycin and moderate hyperthermia by additional use of ethanol

The combined effects of moderate local hyperthermia, bleomycin and ethanol were investigated with Lewis lung carcinoma tumors in female C57BL/6 mice. Different combinations of treatments were performed on days 4 and 7 after tumor implantation. Combined treatment of 41°C hyperthermia and bleomycin resulted in mild reductions of tumor growth. Hyperthermia plus bleomycin led to marked reduction in tumor growth under the condition of a 43°C temperature. The antitumor effects of 41°C hyperthermia combined with bleomycin were enhanced by the additional use of ethanol, and these effects were more remarkable than those of 43°C hyperthermia and bleomycin. A possible application of these findings to clinical therapy for advanced esophageal cancer was discussed.     

Chemo-thermotherapy of radiation-induced squamous cell carcinoma in anterior chest wall]

A 62-year-old woman had visited our hospital with the large and deep ulcer formation on the left anterior chest wall. A biopsy of the ulcerous lesion established the diagnosis of a squamous cell carcinoma which might be induced by the irradiation after mastectomy. Although a wide resection of the chest wall including left arm was performed, it was impossible to resect completely. After then, she had operations for local recurrence for three times in three years. However, cure was not obtained, and residual lesions gradually enlarged and all layers of the anterior chest wall was replaced with tumor tissues. Conventional chemotherapy using ftorafur and mitomycin C was not effective. Therefore, we tried combined therapy with intravenous administration of cisplatin (CDDP) and vindesine (VDS), and local hyperthermia using radiofrequency (RF) wave. A total number of 11 courses of this treatment modality was carried out at once a week intervals. The tumor-temperature was maintained at the range of 40-43 degrees C for 40 min in each treatment session. Chemotherapeutic agents were administered simultaneously with hyperthermia. After these treatments, the recurrent tumor was markedly reduced, and epithelization of the ulcer was recognized from the surrounding normal skin. The residual tumor was then resected completely. The operative wound was successfully closed by surrounding normal tissue mobilization. She is in good postoperative condition. We concluded that the chemo-thermotherapy is safe and promising therapeutic modality for such invasive squamous cell carcinoma, and the normal tissues are not affected. Furthermore, this approach will expand the scope of radical resection for such an uncontrollable tumor.